Latest hospital inspections find good care, but still too much variation

18 ecember 2013

CQC has identified ‘exceptional’ care at Salford Royal NHS Foundation Trust, according to the Chief Inspector of Hospitals, Professor Sir Mike Richards.

Professor Richards was commenting as CQC publishes the latest reports from its new acute hospital inspection programme.  He noted that the four reports demonstrated variations in care: at Salford and Royal Surrey County Hospitals NHS Foundation inspectors found good examples of care, but at the Royal Bournemouth and Christchurch NHS Foundation Trust and Barking, Havering and Redbridge University Hospitals NHS Trust inspectors noted a number of areas of concern.

Professor Richards said: "We have now published reports on eight trusts following our new-style inspections. The larger teams and the involvement of more clinical specialists and members of the public is giving us a good picture of what care looks like across these large and complex organisations. When we go in, we are looking to see if services are safe, effective, caring, responsive to people’s needs and well-led.

"Our reports show a mixed picture of care, but I am particularly pleased that we have seen good examples of care, even in hospitals where the overall findings have not been positive. I want hospitals to learn from each other to help them improve their services and we will continue to highlight good practice where we find it."

All of the inspection teams included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts. They carried out a mixture of announced and unannounced inspections, held focus groups with staff, and held a public listening event. The reports are based on a combination of inspection findings, information from CQC’s Intelligent Monitoring system, and information provided by patients, the public and other organisations.

Professor Richards said: "Salford Royal strives to be the best in the country and to deliver care which is safe, clean and personal every time.   We found it is an extremely well-run trust, with a strong and stable leadership which was embedded at all levels within the trust, across all wards, consistently and without fail.

"Staff were encouraged to be innovative in improving the quality of care. They were able to tell us how quality was given a high priority and that patient care was personalised.

"The trust showed an openness and commitment to continuous improvement, with patient safety at the top of its priorities."

Examples of good practice at Salford included the bereavement service, the electronic patient records system and the trust’s system for being transparent about staffing levels. Inspectors also praised the “exceptional leadership qualities at all levels across all staff groups” and noted that “the engagement and leadership on the non-executive directors and the governing council were outstanding”.

At the Royal Surrey County Hospital, inspectors noted good practice in a number of areas including the paediatric ward, the maternity service and nurse-led cancer clinics. Professor Richards said: "Staff we spoke to were positive and engaged, and patients we spoke to were generally very positive about the care that they had received at the hospital."

At the other end of the scale, Professor Richards has recommended that the Trust Development Authority puts Barking, Havering and Redbridge into special measures. He said: "The long-standing issues in the trust’s two A&E departments are clearly affecting patients - and all attempts to address these problems over the last few years have failed to deliver.

"While we understand that the leadership team is trying to resolve the issues, it is clear to us the Trust is unable of doing so without help. That’s why we’ve asked the NHS Trust Development Authority to put this trust in special measures to tackle the issues it faces."

The Royal Bournemouth Hospital also came in for criticism from inspectors, who found that medical care, including older people’s care was inadequate. A&E, surgical services and outpatient services also required improvements. Professor Richards said: "The hospital had a high occupancy rate and there had been ongoing use of escalation beds when a ward or unit was full - even though these beds could not meet patients’ needs properly. The trust did not employ enough staff, even though it was fully aware that nearly all its beds were occupied all the time."

The reports are clear about where the hospitals in question need to make improvements. Inspectors will return to the trusts to follow up the findings from these inspections and to report on progress in making the required improvements.

You can read the full reports on the pages below:

• King George Hospital
• Queen's Hospital
• Royal Bournemouth Hospital
• Royal Surrey County Hospital
• Salford Royal Hospital

Notes to editors

Contact the press office for copies of the reports

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